3种压疮评估量表对肿瘤内科患者临床效度的测定

The clinical validity of 3 kinds of pressure ulcer assessment scale for cancer patients in department of internal medicine

目的测定和比较Braden、Waterlow、Norton 3种压疮评估量表在新疆不同民族肿瘤内科住院患者中的临床效度。方法选取2015年6-10月350例新疆某三级甲等医院肿瘤内科住院患者,应用3种压疮危险因素评估量表进行压疮风险评估,现场评估并记录患者皮肤的完整性及皮肤颜色的变化,比较3种压疮危险因素评估量表的灵敏度(Se)、特异度(Sp)和Youden指数。结果对肿瘤患者进行压疮风险因素识别时,Braden量表的平均得分为(16.71±3.74)分,Waterlow量表的平均得分为(14.44±5.70)分,Norton量表的平均得分为(15.67±2.44)分。350例患者中识别压疮55例(55处),识别率为15.7%。Ⅰ期51处,Ⅱ期4处;最易发生压疮的部位是骶尾部,共33处,其次是两侧髂脊10处,髋部8处,足跟2处,其他2处。通过3种压疮危险因素评估量表的测定,对于总体、汉族及少数民族肿瘤内科住院患者,Waterlow量表的灵敏度均较好,Youden指数较大。结论建议临床使用Waterlow量表对肿瘤内科住院患者进行压疮危险因素评估。

Objective To measure and compare the clinical validity of Braden,Waterlow,and Norton three kinds of pressure ulcer assessment scales in cancer patients with different nationalities in the department of internal medicine in Xinjiang.Methods From June to October 2015,350 cases were selected in a tertiary A-level hospital hospitalized patients and measured with 3 kinds of pressure ulcer risk factors assessment tables by assessing on-site and recording the patients skin integrity and skin color changes.The sensitivity（SE）and specificity（SP）of three kinds of pressure ulcer risk factors assessment scale were compared.Results In the cancer patients,the average score of Braden scale was（16.71±3.74）;Waterlow scale average score was（14.44±5.70）;Norton scale average score was（15.67±2.44）.55 pressure ulcers were identified in 350 cases and the recognition rate was 15.7%.including 51 in stage I,4 in stage II;the predilection site of pressure parts was sacrococcygeal region（33 cases）;followed by 10 on both sides of the iliac crest,hip,heel,the other two.For all of Han and minority medical oncology inpatients,in the three assessment scale,the sensitivity of the Waterlow scale was the best,and the Youden index was largest.ConclusionWaterlow scale was recommended for the assessment of pressure ulcer to the patients in the department of internal medicine.